Built on the most widely accepted credentialing standard in healthcare

This guide breaks down the core systems, data, and business decisions required for Medicare credentialing, so providers better understand how to properly set up and manage their CAQH, NPPES, CMS data, access, and enrollment information, along with their business structure, ownership, and reporting requirements. What’s Covered: • CAQH profile setup and management • NPI registration (NPPES) • CMS Identity & Access (I&A) account setup • PECOS enrollment system overview • How Medicare Administrative Contractors (MACs) work • Business tax structure and ownership setup • Ownership and managing control requirements • Pre-enrollment preparation steps • Individual enrollment application walkthrough • Reassignment of benefits • Group enrollment application walkthrough • What happens after you submit your application • Follow-up and approval process

About the Author

Susie Morozowich, LMSW, LCSW, is the Founder and CEO of TelebehavioralHealth.US, a multi-state group practice providing outpatient behavioral health services. She has spent the past decade building and managing an insurance-based practice, including becoming the first all-digital behavioral health provider to partner with Medicare. Since founding TelebehavioralHealth.US in 2016, Susie has built and maintained payer relationships across Medicare, Medicaid, and commercial insurance networks, supporting participation with more than 40 payers across 15 states. Her experience spans the full credentialing lifecycle, including provider enrollment, system management through platforms such as CAQH, NPPES, and Medicare PECOS, and ongoing contract and network oversight. Susie's work reflects a practical, working knowledge of how credentialing and contracting function within real-world practice, including the interplay between enrollment, reimbursement, compliance, and access to care. Her approach is informed by direct experience navigating these systems at scale, with an emphasis on accuracy, efficiency, and long-term sustainability.

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